Individual provider Active NPI

Darryl Dhaw Hodson, MD

  • Dermatology Physician
  • Warner Robins, GA
National Provider Identifier
1871583351
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
062723 Issued in GA
Practice address
212 Hospital Dr
Suite C
Warner Robins, GA 31088-4207
Phone
(478) 922-9281
Fax
(478) 929-6293
NPI assigned
Oct 25, 2005
Last updated
Apr 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 062723 GA Primary
MOHS-Micrographic Surgery Physician 207ND0101X 062723 GA
Pediatric Dermatology Physician 207NP0225X 062723 GA
Procedural Dermatology Physician 207NS0135X 062723 GA
General Practice Physician 208D00000X 062723 GA
Clinical & Laboratory Dermatological Immunology Physician 207NI0002X 062723 GA
Dermatopathology Physician 207ND0900X 062723 GA

Addresses

Primary practice location

212 Hospital Dr
Suite C
Warner Robins, GA 31088-4207

Mailing address

2400 Bellevue Rd
Suite 21-a
Dublin, GA 31021-2885
Phone (478) 275-7202

Other identifiers 1

IdentifierTypeStateIssuer
155751983OMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090804000707 GA Practitioner - DermatologyPractitioner - General PracticePractitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Pathology 4880770213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: General Practice, Micrographic Dermatologic Surgery (MDS), Pathology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Dermatology and Skin Cancer Center, LLCGroup PAC ID 7113980855, 53 clinicians

Practice addresses (Care Compare)

212 Hospital Dr
Suite C
Warner Robins, GA 31088-4247
Phone (478) 922-9281

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision157
Removal of skin lesions147
Removal of skin cancer1477
Skin biopsy147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Dermatology & Skin Cancer Center, LLC Dermatology CurrentSince Apr 5, 2010 Accepting new patients
Georgia Dermatology &Skin Cancer Center, PC Dermatology Past Accepting new patients
Wesley S Wilborn MD PC Dermatology Past Accepting new patients
Skin Surgery Center PA Mohs-Micrographic Surgery Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1349 Milstead Rd NE
Conyers, GA 30012
Phone (770) 785-7546

2400 Bellevue Rd
Ste 16
Dublin, GA 31021
Phone (478) 275-2694

2400 Bellevue Rd
Ste 21A
Dublin, GA 31021
Phone (478) 275-7202

1157 Forsyth St
Macon, GA 31201
Phone (478) 745-8581

1006 Greenfield Dr
Tifton, GA 31794
Phone (229) 382-8822

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1871583351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD",
            "address_2": "SUITE 21-A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212885",
            "telephone_number": "478-275-7202",
            "fax_number": "478-274-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HOSPITAL DR",
            "address_2": "SUITE C",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310884207",
            "telephone_number": "478-922-9281",
            "fax_number": "478-929-6293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODSON",
        "first_name": "DARRYL",
        "middle_name": "DHAW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "062723",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "GA",
            "license": "062723",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "GA",
            "license": "062723",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "GA",
            "license": "062723",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "062723",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "GA",
            "license": "062723",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "GA",
            "license": "062723",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155751983O",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.